Information about dental care using intravenous (IV) sedation for adult patients

Intravenous sedation involves you having sedative drug/ drugs given to you by injection into a vein. The sedation makes you drowsy and helps reduce anxiety.

A flexible plastic tube called a cannula is put into a vein in the back of your hand or in your arm. A needle is used to put the cannula into place, and is then removed immediately. It is normal to feel a sharp scratch when the cannula is being put into place. Once the cannula is in place, the sedation drug(s) can be given. The cannula is left in place until the appointment is finished and you are recovered. It will then be removed before you go home.

During intravenous sedation you will still be aware of what is going on but will feel more relaxed.

You may experience a temporary loss of memory during the time you are sedated, however this is not the case for everyone. You may feel unsteady on your feet for some hours after the procedure. Your ability to think clearly and make judgements may be affected for the next 24 hours. You may experience forgetfulness.

Once you are sedated, the dentist will use numbing injections (local anaesthetic) for fillings and all teeth that have to be taken out. Some paste can be used to make the area beside your tooth numb. The injection will then be given through this numbed area to help make the procedure more comfortable.

It is usual to have at least two to three appointments. The first appointment will be an assessment when your dental treatment under sedation will be discussed and planned with you. The dental treatment under sedation will take place at second and subsequent appointments.

Your dentist and members of the dental team are trained to give sedation. They watch you closely and treat any problems that may develop. They are also required to use monitoring equipment during the sedation, to check your heart rate, breathing rate and oxygen levels. You will be observed until you have made a full recovery from the sedation.

Unlike a general anaesthetic, where you are completely asleep, the main benefits with intravenous sedation is that it is often safer, quicker and more convenient.

Your discharge home and recovery time will be quicker than having a general anaesthetic and all the treatment can be provided in the dental surgery rather than having to go to hospital.

Yes. As with the administration of any medicines, there are risks associated with intravenous sedation.

The common risks may include:

• Drowsiness (feeling tired)
• Amnesia (memory loss)
• Disorientation (dizziness and/or confusion)
• Nausea (feeling sick)
• Bruising at the site of the cannula. This may take several days to fade.
• A reduction of oxygen in the blood stream due to poor/reduced breathing during sedation. This will be monitored during the procedure. You may be asked to take deep breaths to correct this.

Very rare risks may include:

• Vomiting (being sick)
• Allergy to the sedative drugs

Sometimes the intravenous sedation can cause a person to share information of a personal nature. If you do share information, this will be treated confidentially.

It is important to let the dentist know your medical history, including any medications that you are taking. The dentist will need to know if you have ever had any problems with having either intravenous sedation or a general anaesthetic.

If you are or may be pregnant, or you are breastfeeding, please let the dentist know as soon as possible.

Yes, dental treatment can also be carried out in the following ways:

Without any sedation

Just using an injection to numb the treatment area inside the mouth (local anaesthesia).

With the use of oral sedation or inhalation sedation

Oral sedation involves a medication given by mouth. Inhalation sedation involves breathing a gas through a nosepiece. Both methods still require local anaesthesia to make the mouth numb too.

Treatment under general anaesthesia

This involves going to sleep. The risk of a very serious complication with this form of treatment is very rare, about 1 in 100, 000 for a healthy adult. The risk is therefore small but much greater than that of intravenous sedation.

Your dentist will discuss these different options with you and why they think intravenous sedation might be the best way of providing treatment for you

Yes - please follow these important instructions before treatment under IV sedation.

Eating and drinking:

MORNING APPOINTMENT- no food to be eaten after midnight the night before, you can drink a glass of water only up to 2 hours before your appointment.

AFTERNOON APPOINTMENT - you can eat a light breakfast before 7am. After this time, you can drink a glass of water only up to 2 hours before your appointment.

You must attend all appointments with a responsible adult as an escort for you. If you do not have an escort, you will not be able to have your procedure under IV sedation.

Please do not bring any children with you. Child care should be arranged before your appointment.

Do not wear make-up or nail varnish.

Wear flat shoes and warm clothing. On a cold day, please wear some warm gloves.

if you wear contact lenses, you may wish to use your glasses on the day of your appointment instead.

Bring all your regular medications with you, including a recent list of those prescribed.

If you are unwell on the day with cold/flu symptoms or any contagious illness, please contact the clinic for advice as the appointment may need to be rearranged.

Yes - please follow these important instructions after treatment under IV sedation.

You may feel relaxed/sleepy after recovery. This is quite normal but you should not drive a car, ride a bicycle or operate machinery for 24 hours after your treatment.

Avoid any strenuous physical exercise (e.g. cycling/ football/running etc.) for the rest of the day, especially if you have had any teeth taken out.

Go straight home with your escort, by private car or taxi. Do not use public transport.

Your lips, cheeks and/or tongue will be numb after any local anaesthetic. Please be careful not to bite your cheeks, lips or tongue while they are still numb.

Most healthy adults are suitable for intravenous sedation. Your dentist will assess whether or not intravenous sedation might be suitable for you. Some medical conditions and medications may mean that intravenous sedation is not suitable. The dentist will discuss this with you and the alternative options available to you.

You will be discharged home once you are recovered enough from the sedation drug(s).

You are likely to feel sleepy and unsteady after your appointment and you may be disorientated (dizzy and/or confused).

You may have some memory loss, but this is not always the case.

You may have impaired judgement (ability to think clearly) for up to 24 hours due to the drugs used for sedation.

For 24 hours, you should not:

• drive a vehicle, ride a bicycle, operate machinery or use household appliances
• cross the road unsupervised
• drink alcohol
• take sleeping tablets
• go to school/college or work
• make any irreversible decisions, sign legal documents or use social media
• be responsible for any minors/others dependent on care

No, you should return straight home with your escort. You should not return to work until at least 24 hours after your treatment. Taking the day off after your treatment is advisable to recover fully. You may need additional time off if you do not feel fully recovered.

Yes, the teeth having treatment (fillings or extractions) will still need to be made numb using a dental injection of local anaesthetic. This is to make the treatment as comfortable and as acceptable as possible.

The best way to avoid getting dental decay in your teeth is to:

• Reduce the number of sugary snacks and drinks between meals and during the day.
• Keep juice/fizzy drinks to mealtimes only and in between meals only drink milk/water.
• Brush your teeth well using at least a 1350 part per million (ppm) fluoride-containing toothpaste at least twice a day for 2 minutes. One time to be at night before bed and one other time of day.
• Do not rinse away the toothpaste foam, just spit it out. Do not rinse or drink for 30 minutes afterwards.

The best way to keep your gums healthy is to:

• Remove all plaque from the gum margins twice a day, using a toothbrush, dental floss and interdental brushes if gaps are big enough.
• Do not smoke.

Attending regular dental examination appointments can help early detection of problems and can offer prevention advice and treatment. It is important to continue having your teeth checked after your sedation treatment has been completed.

Before treatment

• Escort available to provide 24 hour supervision after treatment.
• Escort and patient not under influence of drink or drugs.
• Follow instructions for eating/drinking:
• MORNING APPOINTMENT- no food to be eaten after midnight the night before, you can drink a glass of water only up to 2 hours before your appointment.
• AFTERNOON APPOINTMENT - you can eat a light breakfast before 7am. After this time, you can drink a glass of water only up to 2 hours before your appointment.
• No makeup / nail varnish.
• Flat shoes and comfortable clothing. Gloves if weather is cold.
• Consider wearing glasses rather than contact lenses.
• Bring medications/medication list with you.
• If you have a cold / illness, your medical history or medication has changed or you think you are pregnant, please contact the sedation clinic.

After treatment

• Return home immediately by private car or taxi. Do not use public transport.
• Not responsible for any minors/others dependent on care during this time.
• Follow the instructions given to you by the dentist.

Barnsley (New Street)
Telephone: 01226 645150

Doncaster (The Flying Scotsman Centre)
Telephone: 01302 563163

Rotherham (Rotherham Community Health Centre)
Telephone:01709 423110